CHAPTER 2: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 2: Values, Beliefs, and Caring Multiple Choice Questions 1. The nurse identifies the concept of enduring ideas about what a person considers desirable or has worth in life is known by which term? A. Values B. First-order belief C. Higher-order belief D. Stereotype Answer: A Explanation: Values are enduring ideas about what a person considers good, right, or desirable in life, forming the basis for decision-making and behavior. They reflect deeply held beliefs about worth and morality. Why Other Options Are Wrong: B refers to foundational beliefs derived from direct experiences. C involves beliefs derived from reasoning. D describes oversimplified generalizations about groups. 2. A group of nursing students are discussing the history of nursing with a staff nurse. When a student states, "Yeah, nurses used to be called the doctors' handmaidens," the staff nurse recognizes that this comment is identified by which term? A. Prejudice B. Generalization C. Stereotype D. Belief Answer: C Explanation: A stereotype is a fixed, oversimplified belief about a group, such as the historical portrayal of nurses as subordinate to doctors. It ignores individual differences within the group. Why Other Options Are Wrong: A involves a preformed negative opinion about a group. B is a broad statement to categorize information. D is a personal perception of reality. 3. A values system is a set of somewhat consistent values and measures organized hierarchically into a belief system. The nurse knows that a value system is also identified by which concept? A. It is culturally based. B. It is unique to each individual. C. It is a poor basis for making decisions. D. It is rigid and uniform within a culture. Answer: A Explanation: Value systems are shaped by cultural norms and learned through socialization, influencing moral and ethical principles within a society. Why Other Options Are Wrong: B is incorrect because while values vary among individuals, they are culturally influenced. C contradicts the role of values in guiding decisions. D ignores variability within cultures. 4. The nurse is caring for a patient under arrest for murder and feels repugnance toward the patient while performing duties. The nurse recognizes this situation is identified by which term? A. Value clarification B. Value conflict C. First-order beliefs D. Higher-order beliefs Answer: B Explanation: A value conflict arises when personal values clash with professional responsibilities, such as feeling repulsed by a patient's actions while committed to providing care. Why Other Options Are Wrong: A is a process to resolve conflicts, not the conflict itself. C and D are types of beliefs, not conflicts. 5. While helping patients with values clarification and care decisions, the nurse should complete which action? A. Convince the patient to do what the nurse believes is best. B. Give advice about what the nurse would do. C. Tell the patient what the right thing to do is. D. Provide information so the patient can make informed decisions. Answer: D Explanation: Nurses should empower patients by providing unbiased information, enabling them to make autonomous, informed choices aligned with their values. Why Other Options Are Wrong: A, B, and C impose the nurse's values, undermining patient autonomy. 6. A patient with terminal cancer asks the nurse, "Should I allow CPR if I stop breathing? What do you think?" Which statement by the nurse would be most beneficial? A. "If it were me, I would want to live no matter what." B. "Don't worry. You have plenty of time to decide later." C. "It's totally up to you. Have you discussed this with your family?" D. "Let's talk about what CPR means to you." Answer: D Explanation: Exploring the patient's understanding and feelings about CPR aligns with values clarification, helping them make a personalized decision. Why Other Options Are Wrong: A imposes the nurse's values. B dismisses the patient's concern. C deflects the responsibility without addressing the patient's immediate need. 7. The nurse is observed sitting at a patient's bedside discussing the care plan. Which theory or model reflects this nurse-patient relationship? A. Swanson's Theory of Caring B. Travelbee's human-to-human relationship model C. Watson's Theory of Caring D. Leininger's Cultural Care Theory Answer: A Explanation: Swanson's Theory emphasizes "being with" and "enabling," exemplified by the nurse's presence and collaborative discussion. Why Other Options Are Wrong: B focuses on empathy and compassion. C involves holistic caritas processes. D centers on cultural influences. 8. A student nurse plans care for a patient who believes Western medicine is effective but not always accurate. Which nursing theory best explains the patient's health practices? A. Nursing: Human Science and Human Care B. Theory of Cultural Care Diversity and Universality C. Theory of Nursing as Caring D. Five caring processes Answer: B Explanation: Leininger's theory addresses cultural influences on health beliefs, aligning with the patient's skepticism toward Western medicine. Why Other Options Are Wrong: A focuses on holistic care. C emphasizes nurse-patient shared experiences. D is part of Swanson's theory, not specific to cultural beliefs. 9. Which nursing theorist describes the nurse-patient relationship as a shared lived experience of caring? A. Kristen Swanson B. Jean Watson C. Madeleine Leininger D. Anne Boykin & Savina Schoenhofer Answer: D Explanation: Boykin & Schoenhofer's Theory of Nursing as Caring defines caring as an intentional, authentic shared experience between nurse and patient. Why Other Options Are Wrong: A focuses on caring processes. B emphasizes caritas. C addresses cultural care. 10. A nurse requests a home care referral prior to a patient's discharge. This action best illustrates which of Swanson's caring processes? A. Enabling B. Knowing C. Doing for D. Being with E. Maintaining belief Answer: A Explanation: Enabling involves advocating for patients' future needs, such as arranging post discharge care. Why Other Options Are Wrong: B involves understanding the patient's perspective. C refers to direct care actions. D and E relate to emotional presence and faith in the patient. 11. Which action observed by a nurse manager is not indicative of the qualities and behaviors of caring? A. A staff nurse orders extra desserts for a patient diagnosed with morbid obesity. B. A medication nurse administers scheduled pain medication to patients as ordered. C. A respiratory therapist teaches a patient's spouse how to adjust an oxygen mask. D. A nursing assistant encourages a patient to assist with the morning bath. Answer: A Explanation: Authentic caring involves considering the patient's health needs, not just their immediate desires. Providing extra desserts to a morbidly obese patient contradicts health promotion. Why Other Options Are Wrong: B demonstrates timely pain management. C shows family education. D promotes patient independence - all authentic caring behaviors. 12. The nurse recognizes that when developing a nursing practice, it is important for the nurse to carry out which action? A. Be exposed to negative as well as positive role models. B. Avoid negative role models as much as possible. C. Understand that caring and compassion are taught in class. D. Consider another profession if he/she is not naturally compassionate. Answer: A Explanation: Learning from both positive and negative role models helps nurses develop balanced professional skills and self-awareness. Why Other Options Are Wrong: B limits learning opportunities. C oversimplifies compassion development. D ignores that caring can be cultivated. 13. The nurse is discussing the use of a values clarification tool with a patient. The patient asks, "What is the goal of the values clarification tool?" Which is the best response by the nurse? A. "The tool will help change your value system so that you can make the right decision." B. "The tool will dispel your current beliefs and formulate brand new ones." C. "The tool will assist you in prioritizing your value preferences and help you make decisions." D. "The tool allows you to make decisions without the need of self-awareness." Answer: C Explanation: Values clarification helps patients identify and prioritize their own values to make informed decisions, not change their core beliefs. Why Other Options Are Wrong: A and B incorrectly suggest the tool changes values. D contradicts the purpose of increasing self-awareness. 14. The nurse knows providing care that is consistent and predictable can make the health care experience less intimidating for the patient. What additional action can the nurse take to enhance this experience? A. Explaining what is going to take place beforehand B. Never making promises to patients C. Assuring the patient that his/her requests will get done eventually D. Protecting the patient from knowing why things are happening Answer: A Explanation: Clear explanations reduce anxiety by helping patients understand and anticipate care procedures. Why Other Options Are Wrong: B is unnecessarily restrictive. C creates false expectations. D withholds important information. 15. When planning to change a dressing on an anxious patient, the nurse recognizes which to be the best approach? A. Ask another staff member to perform the task. B. Tell the patient the dressing change will take 30 minutes. C. Schedule a time in collaboration with the patient. D. Review the physician's order prior to the procedure. Answer: C Explanation: Collaborative scheduling gives the patient control and reduces anxiety by creating predictability. Why Other Options Are Wrong: A may increase anxiety by introducing unfamiliar staff. B may create unnecessary stress. D is important but doesn't address anxiety. 16. Collaborating effectively with patients to find treatment methods that are congruent with the patients' belief systems and that promote healthy outcomes is an approach that requires the nurse to include which activity? A. Focus on patient values only and disregard family desires in setting goals. B. Rely more and more on their scientific background. C. Listen carefully to how the patient's beliefs impact their health beliefs. D. Understand that the nurse's beliefs are the most important. Answer: C Explanation: Active listening helps nurses understand how patients' personal beliefs influence their health decisions and preferences. Why Other Options Are Wrong: A ignores important family dynamics. B overemphasizes medical over personal factors. D violates patient-centered care principles. 17. The nurse is caring for a patient scheduled for heart surgery. Which statement made by the patient requires further discussion? A. "My friend died on the operating table several months ago." B. "The surgeon has a great reputation in the community." C. "I believe that this surgery is going to make me better." D. "Yesterday I asked my pastor to visit me after the procedure." Answer: A Explanation: The patient's reference to a friend's death suggests unresolved fears that could impact their surgical experience and recovery. Why Other Options Are Wrong: B shows confidence in the surgeon. C demonstrates positive expectations. D indicates use of spiritual support - all healthy coping mechanisms. 18. The nurse recognizes that a vital aspect of providing effective and appropriate nursing care is being able to actively listen to a patient and then demonstrates this concept when carrying out which activity? A. Pays attention as if in a social conversation with the patient. B. Practices and develops this skill over many years. C. Focuses on what the patient is saying. D. Passively listens with the ears. Answer: B Explanation: Active listening is a developed skill requiring practice and experience to master fully. Why Other Options Are Wrong: A underestimates the focus needed in clinical listening. C is part but not all of active listening. D describes passive, not active listening. 19. The nurse is caring for a patient with lung disease. The patient tells the nurse that the most important thing to do during the shift is to walk down to the nurses' station and back without having shortness of breath. The patient's request is an example of which nursing theory? A. Leininger's Cultural Care Theory B. Boykin & Schoenhofer's Theory of Nursing as Caring C. Swanson's Theory of Caring D. Watson's Human Science and Human Care Theory Answer: C Explanation: Swanson's enabling process focuses on helping patients achieve their self-identified goals, like the walking objective. Why Other Options Are Wrong: A addresses cultural factors. B emphasizes shared caring experiences. D focuses on holistic healing. 20. When the nurse is dealing with the concept of beliefs and values, the nurse recognizes which type is based in the unconscious? A. Zero-order beliefs B. First-order beliefs C. Higher-order beliefs D. Prejudices Answer: A Explanation: Zero-order beliefs are fundamental, often unconscious assumptions about reality that form the basis of conscious thought. Why Other Options Are Wrong: B are conscious foundational beliefs. C are derived through reasoning. D are conscious biased opinions. Multiple Response Questions 21. A nurse working in a dermatology clinic observes that a patient of Mexican-American descent typically arrives 10 to 15 minutes late to every appointment. Based on an understanding of first-order beliefs, what characteristics can the nurse associate with this level of beliefs? (Select all that apply.) A. First-order beliefs serve as the basis of a person's belief system. B. First-order beliefs begin to develop in early adolescence. C. First-order beliefs are completely formed in childhood. D. People seldom question their first-order beliefs. E. Challenging a patient's first-order beliefs may cause cognitive upset. Answer: A, D, E Explanation: First-order beliefs form the foundation of one's belief system (A), are rarely questioned (D), and challenging them can cause distress (E). They begin in childhood but continue developing. Why Other Options Are Wrong: B is incorrect because first-order beliefs begin in early childhood, not adolescence. C is wrong because they continue developing beyond childhood. 22. When dealing with patient who has a values conflict in which substance abuse or an addiction is involved, the nurse should conduct an assessment interview and use which techniques that will make the interview most effective? (Select all that apply.) A. Listen for subtle signs of denial. B. Directly confront the patient about his drug abuse. C. Use a matter-of-fact approach to inform the patient. D. Provide straightforward information. E. Avoid direct confrontation. Answer: A, C, D, E Explanation: Effective approaches include listening for denial (A), using a neutral tone (C), providing clear facts (D), and avoiding confrontation (E) to reduce defensiveness. Why Other Options Are Wrong: B is incorrect because direct confrontation often increases resistance and decreases therapeutic engagement. 23. Caring, according to the American Nurses Association (ANA) Code of Ethics (2015), is having concern or regard for that which affects the welfare of another. The nurse recognizes that as a profession, nursing can trace its earliest beginnings to what types of nurturing activities that demonstrate care? (Select all that apply.) A. Active listening B. Advocating for the vulnerable C. Valuing all individuals D. Separating healing from spirit E. Attempting to relieve pain Answer: A, B, C, E Explanation: Nursing's roots include listening (A), advocacy (B), respect (C), and pain relief (E) as core caring behaviors that address the whole person. Why Other Options Are Wrong: D is incorrect because traditional nursing care integrates physical and spiritual aspects of healing. 24. Touch is the intentional physical contact between two or more people and it is deemed to be an essential and universal component of nursing care. The nurse knows that task oriented touch occurs during which activities? (Select all that apply.) A. Holding the patient's hand during a painful procedure B. Giving the patient an injection to treat discomfort C. Starting an intravenous (IV) line for fluid administration D. Inserting a nasogastric tube to decompress the patient's stomach E. Shaking the patient's hand in order to establish rapport Answer: B, C, D Explanation: Task-oriented touch includes clinical procedures like injections (B), IV starts (C), and NG tube placement (D) that require physical contact to complete treatments. Why Other Options Are Wrong: A and E represent caring touch for comfort or connection, not procedure completion. 25. The nurse recognizes that after several years of work in the emergency room, compassion fatigue has developed. What symptoms associated with this condition would the nurse be experiencing? (Select all that apply.) A. Chronic depression B. Sleeping all the time C. Anorexia D. Poor concentration E. Feeling detached from patients F. Euphoria Answer: A, D, E Explanation: Compassion fatigue manifests as depression (A), difficulty focusing (D), and emotional detachment (E) from patients due to prolonged stress exposure. Why Other Options Are Wrong: B and C are physical symptoms not directly characteristic of compassion fatigue. F is incorrect as euphoria contradicts the distress of compassion fatigue.